P1361Impact of radiation/chemotherapy for breast cancer on the electroanatomic features in patients receiving catheter ablation for left atrial arrhythmia

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
N Schenker ◽  
N Hashiguchi ◽  
T Maurer ◽  
C Lemes ◽  
L Rottner ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Catheter Ablation ◽  
Cancer Treatment ◽  
Left Atrial ◽  
Independent Predictor ◽  
Breast Cancer Treatment ◽  
Control Group ◽  
Study Cohort ◽  
Scar Area ◽  
Significant Difference

Abstract Background Atrial fibrillation (AF) is a common cardiac arrhythmia and catheter ablation a viable treatment option for patients with AF. Extensive left atrial (LA) scars, frequently seen in patients with persistent AF, can limit its efficacy. Radiation for breast cancer treatment is known to have serious long-term effects (e.g. fibrosis) on the targeted tissue. At the same time, chemotherapy often leads to organ dysfunction. We sought to examine the effects of radiation and chemotherapy on the electroanatomic features of the LA in patients who received catheter ablation for left atrial arrhythmias with prior breast cancer treatment. Methods and Results We compared 38 patients (mean age 68.4 ± 7.1 years) who underwent catheter ablation for LA arrhythmia and had a previous diagnosis of breast cancer with 38 patients (mean age 65.4 ± 7.3 years) without breast cancer who formed our control group. LA scar area, as well as its distribution was measured during the electrophysiology (EP) study and graded according to the Utah classification. The existence of LA scarring did not differ significantly between both groups (71.1% vs. 76.3%, p = 0.602). LA scar area (excluding PVs) was 107.5cm2 ± 19.0cm2 in the breast cancer group compared to 110.1cm2 ± 18.5cm2 in the control group (p = 0.536). The distribution of the scar area revealed no significant difference between both groups, however an involvement of the anterior wall was common (65.8% vs. 73.7%; p = 0.454). We further investigated whether the location of breast cancer had an impact on the LA scar development of the patients in our study cohort. Here, we found no significant difference in the amount of LA scarring when comparing patients with left-sided breast cancer to patients with right-sided breast cancer (66.7% vs. 73.9%). In a sub-analysis patients with breast cancer and persistent AF showed a non-significant trend towards greater LA scar areas (17.4cm2 vs. 6.8cm2) in comparison to patients of the control group with similar LA volumes. The patient’s age (>65 years) was the only independent predictor for greater LA scarring we could identify. Neither former radiotherapy, nor chemotherapy showed a positive correlation with greater LA scarring. Conclusion There is no change in the distribution as well as an increase of the extent of LA scars after thoracic irradiation and/or chemotherapy. A trend towards greater LA scar areas was seen in patients with breast cancer and persistent AF. The patient’s age was identified as an independent predictor for LA scar development.

scholarly journals Cardiotoxicity in breast cancer treatment: What about left ventricular diastolic function and left atrial function?

2019 ◽  
Vol 36 (10) ◽  
pp. 1806-1813 ◽  
Author(s):  
Ana Teresa Timóteo ◽  
Luisa Moura Branco ◽  
Frederico Filipe ◽  
Ana Galrinho ◽  
Pedro Rio ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Treatment ◽  
Diastolic Function ◽  
Left Atrial ◽  
Left Ventricular Diastolic Function ◽  
Breast Cancer Treatment ◽  
Left Ventricular ◽  
Atrial Function ◽  
Left Atrial Function ◽  
Ventricular Diastolic Function

The Impact of Facility Volume/Size on Breast Cancer Treatment and Outcome

2010 ◽  
Vol 76 (12) ◽  
pp. 1333-1337 ◽  
Author(s):  
Jack Sariego
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Cancer Treatment ◽  
Breast Cancer Treatment ◽  
Definitive Treatment ◽  
Treatment Facility ◽  
Cancer Data ◽  
Stage Distribution ◽  
Significant Difference ◽  
The Impact

Recent studies have suggested that outcomes and survival from breast cancer are improved when definitive treatment is rendered at high-volume and/or teaching centers. Consolidation of such cases in tertiary centers, however, is often impractical and impossible. Patients often desire primary treatment of their breast cancer in their own communities. The current study was undertaken to examine the impact of treatment facility type on the treatment performed as well as on overall survival. Breast cancer treatment and survival data were available from the American College of Surgeons National Cancer Data Base. Only patients in whom no previous treatment had been rendered were included in the analysis. Data were stratified with regard to type and size of treatment facility/hospital; stage distribution; initial treatment performed; and 1-, 2-, and 5-year survival. A total of 665,409 patients were included in the current analysis. There were no significant differences in stage distribution between facility types nor was there a significant difference in the treatment performed (although there was a slight trend toward breast conservation at the larger centers). This was true overall and for each stage of cohort. There were also no significant differences in 1-, 2-, and 5-year survival rates overall and at any stage (although again, there was a slight trend toward a minimal survival advantage at the larger centers). There was no significant impact of facility size or type on either breast cancer treatment performed or overall survival. There was no evidence that more “advanced” treatments were offered at larger centers nor was there evidence of improved outcome/survival at larger centers. Care can be rendered safely, efficiently, and effectively in the community setting.

scholarly journals Effect of Selected Factors on the Serum 25(OH)D Concentration in Women Treated for Breast Cancer

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 564
Author(s):  
Agnieszka Radom ◽  
Andrzej Wędrychowicz ◽  
Stanisław Pieczarkowski ◽  
Szymon Skoczeń ◽  
Przemysław Tomasik
Keyword(s):  
Breast Cancer ◽  
Vitamin D ◽  
Cancer Treatment ◽  
Serum Vitamin ◽  
Study Groups ◽  
Breast Cancer Treatment ◽  
Vitamin D Supplementation ◽  
Control Group ◽  
Average Dose ◽  
Serum Vitamin D

Maintaining an optimal vitamin D concentration reduces the risk of recurrence and extends survival time in patients after breast cancer treatment. Data on vitamin D deficiency among Polish women after breast cancer therapy are limited. Thus, the aim of the study was the analysis of vitamin D status in post-mastectomy patients, considering such factors as seasons, social habits, vitamin D supplementation and its measurements. The study involved 94 women after breast cancer treatment. Serum vitamin D concentration was measured, and a questionnaire, gathering demographic and clinical data regarding cancer, diet, exposure to sun radiation, and knowledge of recommendations on vitamin D supplementation, was delivered twice, in both winter and in summer. The control group consisted of 94 age-matched women with no oncological history. In women after breast cancer treatment, 25-hydroxyvitamin D (25(OH)D) deficiency was much more frequent than in the general population. Only about half of the patients supplemented vitamin D at the beginning of the study. After the first test and the issuing of recommendations on vitamin D supplementation, the percentage of vitamin D supplemented patients increased by about 30% in study groups. The average dose of supplement also increased. None of the women that were not supplementing vitamin D and were tested again in winter had optimal 25(OH)D concentration. It was concluded that vitamin deficiency is common in women treated for breast cancer. Medical advising about vitamin D supplementation and monitoring of 25(OH)D concentration should be improved.

scholarly journals A preliminary study of manipulation under anaesthesia for secondary frozen shoulder following breast cancer treatment

2014 ◽  
Vol 96 (2) ◽  
pp. 111-115 ◽  
Author(s):  
A Leonidou ◽  
DA Woods
Keyword(s):  
Breast Cancer ◽  
Cancer Treatment ◽  
Corticosteroid Injection ◽  
Frozen Shoulder ◽  
Breast Cancer Treatment ◽  
Control Group ◽  
Study Group ◽  
Breast Cancer Patients ◽  
Manipulation Under Anaesthesia ◽  
Preliminary Study

Introduction The aim of this paper is to present the results of manipulation under anaesthesia (MUA) and injection of local anaesthetic and corticosteroid followed by a physiotherapy regime for secondary frozen shoulder after breast cancer treatment (surgery, radiotherapy), and to compare them with a control group. Methods Patients referred to the senior author for secondary frozen shoulder following breast cancer treatment over a ten-year period were investigated. Recorded data included age, treatment for breast cancer, length of symptoms, Oxford shoulder score (OSS) and range of motion before and after shoulder MUA. These data were compared with a control group of patients with frozen shoulder. Results A total of 263 patients were referred with 281 frozen shoulders. Of these, 7 patients (7 shoulders) had undergone previous breast cancer treatment and the remaining 256 patients (274 shoulders) formed the control group. None of the patients were diabetic. The mean preoperative OSS was 31 for the study group and 27 for the control group, improving to 43 for both groups following MUA. Forty-two per cent of the study group and fifteen per cent of the control group had a second MUA subsequently. At the long-term follow-up appointment, 71% of the study group patients were satisfied with their result. Conclusions The results of this preliminary study suggest that MUA, corticosteroid injection and subsequent physiotherapy have achieved good final results in a series of patients with frozen shoulder secondary to breast cancer treatment. Members of the multidisciplinary team looking after breast cancer patients should be aware of this management option and, on manifestation of this pathology, should refer the patient to an orthopaedic surgeon.

ORAL SIDE EFFECTS OF SYSTEMIC TREATMENT IN WOMEN WITH BREAST CANCER VISITING REHMAN MEDICAL INSTITUTE PESHAWAR : A CROSS-SECTIONAL SURVEY

JKCD ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. 12-14
Author(s):  
Amjid Ali
Keyword(s):  
Breast Cancer ◽  
Health Status ◽  
Oral Health ◽  
Cancer Treatment ◽  
Oral Health Status ◽  
Breast Cancer Treatment ◽  
Medical Institute ◽  
Control Group ◽  
Cross Sectional ◽  
Immunological Therapy

Objectives: The aim of the study was to characterize the oral health in breast cancer survivors treated in the Rehman Medical Institute, Peshawar. Materials & Methods: This was a cross-sectional study conducted at the Rehman Medical Institute Peshawar between Jan 2017 and June 2018 of women diagnosed with Breast Cancer who received care. Forty three patients were selected in both breast cancer groups as well as in control group. Initially diagnosed patients of breast cancer, followed by surgical therapy and additional radio and chemotherapy were included in this study. Whereas female patients who received (supplementary/solely) endocrine or immunological therapy were excluded from this study, similarly were the women with severe chronic diseases such as chronic heart disease, chronic obstructive pulmonary disease and other cancers. Statistical analysis analysis were performed with the SPSS , Version 22.0. Results: Unfavorable oral health status of women who received breast cancer treatment compared to the oral health status of the control group has been shown in this study. Conclusion: Results indicate a need for more education about the potential oral effects of breast cancer therapies and about providing the best possible care for patients undergoing breast cancer treatment.

The effects of complete decongestive therapy on the extent of secondary lymphoedema in women after breast cancer treatment

Physiotherapy ◽  
2015 ◽  
Vol 23 (1) ◽  
Author(s):  
Iwona Malicka ◽  
Dawid Marciniak
Keyword(s):  
Breast Cancer ◽  
Cancer Treatment ◽  
Breast Conserving Surgery ◽  
Breast Cancer Treatment ◽  
Post Treatment ◽  
Control Group ◽  
Study Group ◽  
Complete Decongestive Therapy ◽  
The Mean ◽  
Decongestive Therapy

AbstractAim of the study was to assess the effects of Complete Decongestive Therapy (CDT) on the extent of lymphedema of the upper extremity in women post cancer treatment.Study group: 20 women after breast cancer treatment with a mean age of 63.15 years (± 8.15). The group was intentionally divided into 2 groups: patients with lymphedema and patients without lymphedema. The first group (study group, n = 10) consisted of women who received CDT. 70% of them had undergone mastectomy and 30% – breast-conserving surgery. In addition, 60% had received radiotherapy, 70% – chemotherapy and 80% – hormone therapy. The mean post-treatment period was 6.2 ± 3.5 years. Patients in the second group (control group, n = 10) did not receive any anti-edema treatments. 90% of them had undergone mastectomy and 10% – breast-conserving surgery. In addition, 40% of study participants had received adjuvant treatment in the form of radiotherapy, 80% – chemotherapy and 50% – hormone therapy. The mean post-treatment period was 6.3 ± 4.4 years. Method: The extent of lymphedema was measured using a centimeter tape and Limb Volumes Professional 5.0 software.A significant reduction in the extent of lymphedema (p = 0.005) was achieved in the CDT group between baseline and post-treatment assessments. No such reduction, however, was found in the control group (p = 0.33).Complete decongestive therapy is an effective method of treatment of lymphedema in women post breast cancer treatment.

Are high mastectomy rates associated with unwanted variation in other aspects of breast cancer treatment? An overview of practice patterns in Alberta, Canada in 2009-2010.

2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 102-102
Author(s):  
Sarah Morrissey ◽  
May Lynn Quan
Keyword(s):  
Breast Cancer ◽  
Adjuvant Therapy ◽  
Cancer Treatment ◽  
Practice Patterns ◽  
Guideline Implementation ◽  
Breast Cancer Treatment ◽  
Study Cohort ◽  
Treatment Practices ◽  
Knowledge Translation Strategies ◽  
Performance Report

102 Background: The Canadian Partnership Against Cancer recently released a system performance report identifying large variation in breast cancer treatment across Canada. Contrary to provincial guidelines, Alberta had higher than average rates of mastectomy (56%); however, factors driving this variation remain unknown. We sought to (1) determine if practice patterns of primary breast surgery and adjuvant therapy adhered to guidelines and (2) to describe influencing factors on treatment practices between the two major cancer programs in Alberta to inform future knowledge translation strategies for guideline implementation. Methods: All patients diagnosed with breast cancer (ICD 9-174) between January 2009 and December 2010 were identified from the Alberta Cancer Registry. Demographic, surgical, treatment, and pathology data were abstracted from the electronic health record. Descriptive statistics and t-testing comparing mastectomy rates, axillary surgery and adjuvant therapy between the two major cancer programs were performed. Results: There were 2,817 surgeries for early breast cancer in the study cohort between 2009 and 2010. Conclusions: Practice patterns identify variance from current guidelines. Mastectomy rates are influenced by surgeon volume and tumor size. Management of positive SN and adjuvant therapy is variable and may reflect under treatment. Further investigation of drivers for mastectomy and adjuvant therapy are necessary. [Table: see text]

Upper limb function: Comparison of postmenopause women with and without a history of early breast cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e20578-e20578
Author(s):  
Nasim Foroughi ◽  
Mi-Joung Lee ◽  
Sharon Kilbreath
Keyword(s):  
Breast Cancer ◽  
Cancer Treatment ◽  
Early Breast Cancer ◽  
Upper Limb ◽  
Breast Cancer Treatment ◽  
Community Dwelling ◽  
Control Group ◽  
Menopausal Women ◽  
History Of ◽  
Post Menopausal

e20578 Background: Long term upper limb impairments following early breast cancer treatment are commonly reported in women years following surgery. However, the extent to which the symptoms are related to menopause and ageing, rather than cancer, has not been explored. This study aimed to compare upper limb strength, shoulder forward flexion range of motion (FF RoM), and presence of impairments in post menopausal women with and without a history of breast cancer. Methods: Community–dwelling age and body mass index (BMI)-matched post menopausal women with (n=40) and without a history of early breast cancer treatment (n=40) participated. Women with other types of cancer, metastatic cancer, and significant neurological or musculoskeletal history unrelated to breast cancer were excluded. Peak shoulder muscle strength was assessed using pneumatic resistance machines and FF RoM with a digital inclinometer. Participants completed the Disability of arm, shoulder and hand (DASH) questionnaire. Between groups comparison were made using analysis of co-variance with age and BMI as confounding variables. Results: Upper limb strength (206.22±45.0 vs. 225.36±86.9 Nm/kg, p=0.091) and FF RoM (166.75±7.9◦ vs. 170.14±6.9◦, p=0.259) were not significantly different between the study and the control group. There were no significant differences between the groups on any of the DASH sub scores (pain: 9.18±8.1 vs. 8.62±8.2, P=0.770). Conclusions: Upper limb impairments are often presumed to be a consequence of surgical procedures in women with breast cancer. However, some of the symptoms women perceive years following surgery may be related to the changes due to aging or menopause rather than cancer treatment.

scholarly journals Abbreviated Screening Breast MRI in Women at Higher-than-Average Risk for Breast Cancer with Prior Normal Full Protocol MRI

2020 ◽  
Vol 2 (4) ◽  
pp. 343-351
Author(s):  
Michael J Plaza ◽  
Elizabeth Perea ◽  
Marcos A Sanchez-Gonzalez
Keyword(s):  
Breast Cancer ◽  
Breast Mri ◽  
Control Group ◽  
Study Cohort ◽  
Average Risk ◽  
Time Inversion ◽  
Inversion Recovery Imaging ◽  
Significant Difference ◽  
Full Protocol ◽  
Outcome Metrics

Abstract Objective To compare the performance of abbreviated screening breast MRI (ABMR) versus full protocol MRI (FPMR) in women at higher-than-average risk for breast cancer with a prior normal FPMR. Methods ABMR was performed on higher-than-average-risk women who had a prior normal FPMR. ABMR protocol consisted of short inversion time inversion recovery imaging, precontrast, and two early postcontrast sequences acquired in under 10 minutes. Retrospective review of ABMR examinations performed from July 2016 to July 2018 was compared with a control group who underwent routine screening with FPMR who had a prior normal FPMR performed from July 2014 to June 2016. Screening outcome metrics were calculated and compared, adjusting for differences in patient demographics. Results The study cohort included 481 ABMR examinations, while the control group included 440 FPMR studies. There was no significant difference in the abnormal interpretation rate (AIR) or cancer detection rate (CDR) for the ABMR versus the FPMR group (AIR 6.0% vs 6.8% respectively, odds ratio (OR) 0.91, 95% confidence interval (CI): 0.53–1.5, P = 0.73; CDR 8.3 vs 11 cancers detected per 1000 examinations respectively, OR 0.73, 95% CI: 0.20–2.7, P = 0.64). The PPV2 and PPV3 for the ABMR group was 19% and 21% versus 16% and 16% for the FPMR group, with no statistical difference. Sensitivity was 100% in each group with no interval cancers. There was no difference in specificity between the ABMR and FPMR groups, 93% versus 94%, respectively (P = 0.73). Conclusion ABMR may be used to screen higher-than-average-risk women with a prior normal FPMR as outcome metrics are equivalent to FPMR.

scholarly journals Impact of reducing day 1 dexamethasone dose in anthracycline-containing regimens on acute gastrointestinal symptoms associated with breast cancer treatment

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yoshitaka Saito ◽  
Yoh Takekuma ◽  
Takashi Takeshita ◽  
Mitsuru Sugawara
Keyword(s):  
Breast Cancer ◽  
Cancer Treatment ◽  
Gastrointestinal Symptoms ◽  
Complete Response ◽  
Breast Cancer Treatment ◽  
Acute Nausea ◽  
Significant Difference ◽  
Reduced Group ◽  
Delayed Phase ◽  
Steroid Sparing

AbstractThe potential of steroid sparing from day 2 onward is reported in anthracycline-containing regimens for breast cancer treatment. We evaluated whether the reduction of dexamethasone (DEX) dose from 9.9 to 6.6 mg on day 1 is possible in anthracycline-containing treatments. Patients receiving anthracycline-containing regimens were divided into control (9.9 mg DEX on day 1) and reduced (6.6 mg DEX on day 1) groups, and retrospectively evaluated. The complete response (CR) rate and the incidence and severity of nausea, vomiting, anorexia, and fatigue were evaluated. The CR rate in the acute phase (day 1) was 63.1% and 38.1% in the control and reduced groups, respectively, with significant difference (P = 0.01) between the groups. However, no difference was found in the delayed phase (days 2–7). The incidence of anorexia and vomiting during treatment was not statistically different. Severity of nausea tended to, but not statistically, worsen while anorexia significantly worsened in the reduced group. Multivariate analysis suggested that patients < 55 years, with non- or less-alcohol drinking habit (< 5 days/week), and administered reduced-DEX dosage on day 1, have a higher risk of acute nausea development. Thus, reducing day 1 DEX dose in anthracycline-containing regimens is not suitable for acute nausea management.

Sign in / Sign up

Export Citation Format

Share Document